Product : EndNote 2

Author : Srinivas Mantha, MD

Additional Professor. Dept. of Anesthesiology, Nizam's Institute of Medical Sciences Hyderabad 500082 India

Discipline : Medical Scientist

I am a physician scientist by profession. I have been a regular authorized user of EndNote for the past 5 years. I have been using the software for creating a personal bibliography database for my references. Three years ago, my superiors imposed a big responsibility on me of holding entry examination for admission to resident and fellowship programs at our institute. The examination is of multiple choice questions (MCQs) type for 14 different programs with 150 questions for each program. Then, one idea struck my mind to make use of EndNote for creating a database for MCQs. I created a new reference style using the unused reference style with the fields as listed below:

It is important to note use of each of the field

The ‘keywords field’ allows us to search question belonging to a particular category of subspecialty. For example, internal medicine has different subspecialties such as cardiology, neurology, pulmonology, gastroenterology, rheumatology, nephrology, infectious diseases etc.

The field ‘paper’ serves to inform the subject and the year in which a particular question was asked.

A ‘random number’ field is necessary for good mixing of questions. When entering each question, a random number generated from a spreadsheet in another window is cut and pasted in the field. I use Minitab to generate random numbers (0 to 1 with uniform distribution, for example 0.093954 0.257100 0.222457 0.711018 0.084146 0.627978 0.343208). After the required questions are selected for a particular subject (e.g. medicine-1999), the questions can be sorted according to the random number field. In addition, the random number also serves as a unique identifier for a question.

The last field i.e. ‘item analysis’ may be necessary to give information about the validity of a question based on the performance of the candidates on that particular question. For example, variables typically used are as follows: difficulty rating (percentage of candidates answering the question correctly), index of discrimination (difference in performance by toppers i.e. top one-third and bottom one-third), phi-coefficient, and statistical significance. For details on item analysis, one can refer to ‘Psychological Testing’ Anastasi A and Urbina S. 7th edition, 1997, Prentice Hall, New Jersy, ISBN: 0-02-303085-2

After questions are selected for a particular examination, exporting the ‘generic-year’ field (i.e. question field) with bibliography number makes the question paper, while exporting the secondary author generic field makes the key to the question paper.

I have been using EndNote for MCQ database for the past three years with several thousands of questions currently in the database. An EndNote file with a few more sample questions along with styles to export and make a question paper and the key may be requested from me.

Advantages of EndNote for creating a MCQdatabase

1. The user friendliness of ‘find’ command with operators such as ‘and, ‘or’, ‘not’ allows easy finding of the questions suited for a particular subject with use of keywords. The ‘not’ in the ‘find’ command is particularly useful to avoid those questions asked in the immediate previous year.
2. The ‘list terms’ facility in a field greatly facilitates entering keywords without typographical errors.
3. Speed of searching questions
4. Ease of exporting and creating a question paper and key for the paper

Limitations of EndNote for creating a MCQdatabase

1. Lack of password facility during saving (as in Microsoft Word or Excel)when creating a new database. Such facility is important for security purposes.
2. EndNote does not have facility to store a BMP (bitmap file) in a field. This limits making questions with a figure. Currently, I paste the pictures after questions are exported to Word. In this era of large capacity harddisks and availability of writable compact disks (CDs), a large space required to store and backup EndNote files with pictures is not a problem.
3. Another major limitation is lack of automatic random number generation in a field. Unfortunately, random numbers generated in a spreadsheet cannot be pasted in a text file and then imported to ‘list’ because the numbers are automatically sorted from minimum to maximum which nullifies the whole purpose of random number usage.
4. Lack of spell check facility. Currently, I spell check after exporting to MS-Word.

Suggestions to Niles for modifying the future versions of EndNote to facilitate creating a MCQ database for examinations.

1. Password facility when creating a new EndNote file.
2. Facility to store a BMP file in a field
3. Automatic random number generation in a field
4. Spell check facility

These facilities, if provided, will greatly benefit the directors of MCQ examinations at different institutions to make the best use of EndNote.